Advanced Practice Toolkit 

3. What makes the AP role special? 

Historically, there has been a tension between the idea of advanced practice as a specific role or as a level of practice, and between the idea of advanced practice as a way of addressing workforce pressures and shortages amongst doctors, or as a level of skilled expertise that is complementary to medical skills. A detailed exploration of this tension is beyond the scope of this toolkit, and more information can be found in the accompanying literature review [50]. In Nottinghamshire, we believe that Advanced Practice roles are at their most useful when they are viewed as expert roles in their own right. Advanced Practitioners, including AHP Advanced Practitioners, have important expertise that is in addition to the medical model; for example, a hospital consultant may refer to an advanced clinical practitioner physiotherapist or occupational therapist because their expertise is more appropriate to that patient’s recovery than surgery or pharmacological treatment at that time. It is a level of practice that is open to a number of registered healthcare professionals, not a highly experienced individual from any specific background role. With this in mind, the role must be a clearly defined role offering specific added value to patients, and not seen as an automatic stage in a career on the basis of length of service [25]. 
As well as working across the four pillars, at an advanced level, the Advanced Practice role is highly autonomous and independent. Transition to this level of practice is key to the success of the individual Advanced Practitioner, and is discussed below. 
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